keyword
https://read.qxmd.com/read/32238087/effects-of-arterial-blood-supply-and-venous-return-on-multi-territory-perforator-flap-survival
#21
JOURNAL ARTICLE
Shanshan Xi, Sheng Cheng, Fangmin Meng, Benke Xu, Yaozhi He, Jin Mei, Maolin Tang
This study aimed to design arterial ischemic and venous congested areas on the same multi-territory perforator flap, assessing the effects of arterial blood supply and venous return on flap survival. Totally 68 rats were randomly divided into the experimental (Exp) and control (Con) groups. In the Exp group, flaps were based on left superficial epigastric artery and right superficial epigastric vein. In the Con group, flaps were based on the left superficial epigastric artery and vein. Immediate postoperative ink-gelatin angiography, epidermal metabolite levels detection, tissue edema measurement, survival rate evaluation in half of the flaps and average microvessel density assessment were performed...
June 2020: Journal of Plastic Surgery and Hand Surgery
https://read.qxmd.com/read/32168125/chimeric-anterolateral-thigh-flap-for-primary-functional-reconstruction-of-complex-composite-near-total-hemi-facial-post-excision-defects
#22
JOURNAL ARTICLE
Thalaivirithan Margabandu Balakrishnan, Anand Prasath Jayachandiran, Divya Devi Hariraj, Janadhanam Jaganmohan
INTRODUCTION: Microvascular free tissue transfer has revolutionized the management of complex composite head and neck defects. AIM: To evaluate the functional and aesthetic outcomes in the primary reconstruction of post-excisional near total hemifacial defects with the chimeric anterolateral thigh flaps (cALT). MATERIALS AND METHODS: The author as a prelude to this clinical study has done a cadaveric study on the quadriceps artery angiosome...
March 11, 2020: Journal of Craniofacial Surgery
https://read.qxmd.com/read/32110908/a-new-approach-to-surgical-management-of-tibial-plateau-fractures
#23
JOURNAL ARTICLE
Stuart A Callary, Claire F Jones, Karim Kantar, Heleen Du Toit, Markus P Baker, Dominic Thewlis, Gerald J Atkins, Lucian B Solomon
Tibial plateau fractures (TPFs) are challenging, requiring complex open reduction and internal fixation (ORIF) and are often associated with complications including surgical site infections (SSIs). In 2007, we introduced a novel management protocol to treat TPFs which consisted of an angiosome- or perforator-sparing (APS) anterolateral approach followed by unrestricted weight bearing and range of motion. The primary aim of this retrospective study was to investigate complication rates and patient outcomes associated with our new management protocol...
February 26, 2020: Journal of Clinical Medicine
https://read.qxmd.com/read/31919624/predicting-the-feasibility-of-utilizing-siea-flap-for-breast-reconstruction-with-preoperative-bmi-and-computed-tomography-angiography-cta-data
#24
JOURNAL ARTICLE
Xiaoyu Zhang, Dali Mu, Yan Yang, Wandi Li, Yan Lin, Haoran Li, Jie Luan
BACKGROUND: Diameters greater than 1.5 mm are considered one of the generally accepted criteria for utilizing superficial epigastric artery (SIEA) flaps for breast reconstruction. However, this standard fails to consider individual differences among patients or deep inferior epigastric perforator (DIEP) perfusion of the same angiosome as the SIEA. This study combined the SIEA system with the DIEP system and explored the relationship between the two systems and body mass index (BMI) to theoretically provide a reference for flap choice in the preoperative surgical plan...
February 2021: Aesthetic Plastic Surgery
https://read.qxmd.com/read/31829162/propeller-perforator-flaps-from-the-dorsal-digital-artery-perforator-chain-for-repairing-soft-tissue-defects-of-the-finger
#25
JOURNAL ARTICLE
Haoliang Hu, Hong Chen, Jinjiong Hong, Weisheng Mao, Mintao Tian, Liping Wang, Jianghui Dong, Xueyuan Li
BACKGROUND: When restoring the appearance and function of the fingers, hand surgeons face a challenge in choosing a suitable surgical method to repair finger skin defects. METHODS: In this study, we designed a long elliptical flap based on a propeller perforator flap and located slightly toward the dorsal lateral aspect of the finger. The flap with a pedicle consisting of the dorsal perforator of the distal digital artery and dorsal digital artery perforator chain is rotated to cover a large wound on the distal end...
December 11, 2019: BMC Surgery
https://read.qxmd.com/read/31711652/perforator-artery-repair-in-revascularization-of-extremity-degloving-injuries
#26
JOURNAL ARTICLE
Fatih Kabakaş, İsmail Bülent Özçelik, Berkan Mersa, Dağhan Dağdelen, İbrahim Alper Aksakal, Taçkın Özalp
INTRODUCTION: This article aims to expand the microsurgical treatment options for extremity degloving injuries with perforator artery repairs of the specific degloved angiosomes in upper and lower extremity. METHODS: Fourteen perforator arteries were repaired in seven patients. Four of them had circumferential degloving and 3 of them have non circumferential degloving injury. All had repair of the perforator arteries of the specific degloved segments. Four patients had additional vein repairs but none of the patients had AV shunts...
December 2019: Injury
https://read.qxmd.com/read/31709170/how-to-assess-a-cta-of-the-abdomen-to-plan-an-autologous-breast-reconstruction
#27
JOURNAL ARTICLE
Warren M Rozen, Harmeet K Bhullar, David Hunter-Smith
The deep inferior epigastric perforator (DIEP) flap is recognised as the most popular option for autologous breast reconstruction. Planning of the DIEP flap involves pre-operative assessment of abdominal vascular anatomy with imaging, of which computed tomographic angiography (CTA) has become the mainstay. CTA enables detailed planning of a range of surgical steps, leading to reduced operative times and improved surgical outcomes. The value of CTA is only demonstrated when the relevant vascular anatomy is able to be demonstrated and appraised...
October 2019: Gland Surgery
https://read.qxmd.com/read/31070789/vascular-coverage-of-the-anterior-knee-region-an-anatomical-study
#28
JOURNAL ARTICLE
Lena Hirtler, Anke Lübbers, Claus Rath
Descriptions of vessel angiosomes or perforasomes throughout the human body are quite frequent, and led to the development of flaps nowadays commonly used to surgically cover skin and soft tissue defects. In these procedures, the surgeon requires a profound anatomical knowledge of the respective blood vessels and the extent of the perfused area to define the size of the graft. In the region of the knee joint, descriptions of flaps based on the superior lateral genicular artery and descending genicular artery are quite frequent...
August 2019: Journal of Anatomy
https://read.qxmd.com/read/31044127/mosaic-fleur-de-profunda-artery-perforator-flap-for-autologous-breast-reconstruction
#29
JOURNAL ARTICLE
Lynn Bourn, Radbeh Torabi, Mark W Stalder, Hugo St Hilaire, Robert J Allen, Stephen J Delatte, Tim S Matatov, Rozbeh Torabi, Joseph Zakhary, Oren Tessler
Perforator-free flaps, in autologous breast reconstruction, have expanded to exploit tissue available at smaller donor sites while retaining high success and low risk rates. Abdominal based flaps, such as the deep inferior epigastric perforator, remain the most common; however, when the abdomen is not an appropriate donor site, lower extremity flaps are options. The profunda artery perforator has the benefit of hiding unsightly scar in the gluteal crease but has the drawback of poor donor site volume. Our mosaic fleur-de-profunda artery perforator flap technique for breast reconstruction has shown to increase volume with the addition of a vertical limb, include full angiosome of perforators, and exhibit donor site morbidity equivalent to a medial thigh lift...
March 2019: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/30959534/-the-light-version-of-a-perforator-flap-significance-of-the-keystone-designed-perforator-flap-concept-kdpfc-in-the-lower-extremity
#30
JOURNAL ARTICLE
Hadrian Schepler, Michael Sauerbier, Stephan Grabbe, Stephan Rietz
INTRODUCTION: Since the KDPFC was first described by Behan et al. in 2003, there have been a number of publications about this technique with case series between 1 and 300 flaps, and some have described further modifications of the design of the flap. The flap design resembles the keystone of a Roman arch and is based on the angiosome concept. The flap is a perforator flap, but does not require microsurgical dissection or preparation of the perforators. The technique is efficient and relatively simple to perform...
August 2019: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://read.qxmd.com/read/30921143/transverse-facial-artery-perforators-anatomical-two-and-three-dimensional-radiographic-study
#31
JOURNAL ARTICLE
Antoine Pierrefeu, Sophie Brosset, Morgan Lahon, Samia Guerid, Hristo Shipkov, Fabien Boucher, Pierre Breton, Nicolas Sigaux, Ali Mojallal
BACKGROUND: Increased anatomical knowledge of skin vascularization, such as the recent description of angiosome and perforasome concepts, has led to important innovations in flap surgery. In this sense, few studies have been performed on face vascularization especially for facial artery perforasomes. The aim of this study was to analyze the number, size, and localization of transverse facial artery perforators and their perfusion area. METHODS: Fourteen hemifaces of fresh adult cadavers from the Department of Anatomy of Lyon University were harvested...
April 2019: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/30898505/cutaneous-angiosome-of-the-chimeric-slga-perforator-flap-anatomical-study-and-clinical-considerations
#32
JOURNAL ARTICLE
Clemens Gstoettner, Johannes A Mayer, Martin Aman, Stefan Salminger, Heinz Bürger, Lena Hirtler, Wolfgang Weninger, Oskar C Aszmann
BACKGROUND: The superior lateral genicular artery (SLGA) is the basis for a chimeric perforator flap in the lateral knee region, which may include bone, cartilage, fascia, and/or skin. To the best of our knowledge, a detailed description of the corresponding perforator-based skin area is missing in the literature. The aim of this study was to describe the extent and possible variations of the cutaneous angiosome of the SLGA. METHODS: In an anatomical study on 21 fresh frozen lower limbs, the SLGA was injected with toluidine blue...
July 2019: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/30688878/a-head-to-head-comparison-of-the-vascular-basis-of-the-transverse-myocutaneous-gracilis-profunda-artery-perforator-and-fasciocutaneous-infragluteal-flaps-an-anatomical-study
#33
JOURNAL ARTICLE
Maximilian Zaussinger, Ines E Tinhofer, Ulrike Hamscha, Stefan Meng, Wolfgang J Weninger, Michael S Pollhammer, Georg M Huemer, Manfred Schmidt
BACKGROUND: Perforator flaps of the upper thigh or buttock provide a valuable secondary choice in autologous breast reconstruction. The purpose of this study was to compare the vascular territories and supplying vessels of the transverse myocutaneous gracilis flap, the profunda artery perforator flap, and the fasciocutaneous infragluteal flap. METHODS: In total, 26 lower limbs from 13 fresh specimens were investigated. All flap pedicles were selectively injected with methylene blue, eosin red, or green ink...
February 2019: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/30534500/in-vivo-quantitative-mapping-of-the-perforasomes-of-deep-inferior-epigastric-artery-perforators
#34
JOURNAL ARTICLE
Rachael Leung, Michael P Chae, Vicky Tobin, David J Hunter-Smith, Warren M Rozen
Background: There is limited understanding of anatomy of perforator angiosomes, or "perforasomes," of the deep inferior epigastric artery (DIEA). A perforasome is defined as the territory perfused by a single perforator vessel of a named artery, such as the DIEA. Given the clinical significance of this anatomical concept in microsurgical breast reconstruction, this study is a quantitative investigation of DIEA perforasome characteristics and patterns associated with perforasome size, perforator caliber, location and branching, using computed tomographic (CT) angiography...
October 2018: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/30300224/comparative-study-of-choke-vessel-reconstruction-with-single-and-multiple-perforator-based-flaps-on-the-murine-back-using-delayed-surgery
#35
JOURNAL ARTICLE
Yihua Mao, Hong Li, Maochao Ding, Xiaodi Hao, Jing Pan, Maolin Tang, Shixin Chen
OBJECTIVE: Choke vessels, vascular anastomosis between adjacent angiosome, play an important role in flap expansion and survival. Here we established a flap model with single and multiple perforators to detect and compare the changes in choke vessels, discuss the effect of hemodynamics on the vascular morphology, and explore the underlying mechanism. METHODS: One hundred mice (7-8 weeks) were subjected to a "choke zone" surrounded by 4 perforators on their backs...
January 2019: Annals of Plastic Surgery
https://read.qxmd.com/read/29775982/the-supraclavicular-artery-perforator-flap-a-comparative-study-of-imaging-techniques-used-in-preoperative-mapping
#36
COMPARATIVE STUDY
Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher Hankins, Jaume Masia
BACKGROUND:  The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap. METHODS:  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography...
September 2018: Journal of Reconstructive Microsurgery
https://read.qxmd.com/read/29062637/visualization-of-skin-perfusion-by-indocyanine-green-fluorescence-angiography-a-feasibility-study
#37
JOURNAL ARTICLE
Johannes Steinbacher, Hidehiko Yoshimatsu, Stefan Meng, Ulrike M Hamscha, Chun-Sheng Chan, Wolfgang J Weninger, Chieh-Tsai Wu, Ming-Huei Cheng, Chieh-Han John Tzou
Plastic and reconstructive surgery relies on the knowledge of angiosomes in the raising of microsurgical flaps. Growing interest in muscle-sparing perforator flaps calls for reliable methods to assess the clinical feasibility of new donor sites in anatomical studies. Several injection techniques are known for the evaluation of vascular territories. Indocyanine green-based fluorescence angiography has found wide application in the clinical assessment of tissue perfusion. In this article, the use of indocyanine green-based fluorescence angiography for the assessment of perforasomes in anatomical studies is described for the first time...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/28953725/the-functional-angiosome-clinical-implications-of-the-anatomical-concept
#38
JOURNAL ARTICLE
G Ian Taylor, Russell J Corlett, Mark W Ashton
BACKGROUND: The angiosome is a three-dimensional block of tissue supplied by a source vessel with its boundary outlined either by an anastomotic perimeter of reduced-caliber choke vessels or by true anastomoses with no reduction of vessel caliber. This article focuses on the role of these anastomotic vessels in defining flap survival or the necrotic pattern seen in fulminating meningococcal septicemia. METHODS: Experiments in pigs, dogs, guinea pigs, and rabbits over the past 46 years were reviewed, focusing on the necrosis line of flaps, the effects of various toxins in vivo, and correlating these results in the clinical setting...
October 2017: Plastic and Reconstructive Surgery
https://read.qxmd.com/read/28434811/predicting-and-planning-for-siea-flap-utilisation-in-breast-reconstruction-an-algorithm-combining-pre-operative-computed-tomography-analysis-and-intra-operative-angiosome-assessment
#39
JOURNAL ARTICLE
Francis P Henry, Daniel P Butler, Simon H Wood, Navid Jallali
BACKGROUND: Low flap complication rates and excellent aesthetic outcomes are now commonplace in breast reconstruction. As a result, attention is now being focussed on minimising donor site morbidity. Despite its potential donor site advantages, the superficial inferior epigastric artery (SIEA) flap is often discounted, given concerns about the high flap failure rates. In this study, we present our experience of using the SIEA flap in breast reconstruction and provide an algorithm based on pre-operative computed tomography angiography (CTA) to aid pre-operative planning...
June 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://read.qxmd.com/read/27919616/supermicrosurgery-assisted-venous-supercharging-of-a-reverse-flow-angular-artery-perforator-flap-for-nasal-reconstruction
#40
JOURNAL ARTICLE
R Vijayan, F Al-Aswad, R Y Kannan
The centre ground in the world of flaps have over time, gradually shifted from tubed pedicled, random-pattern, axial-pattern, pedicled, free and currently, to free-styled flaps. These concepts are broadly based on the angiosome-perforasome concept. In this case report, we illustrate how the concept of venosome capture can be transposed onto reverse-flow flaps with the aid of venous supercharging. Moreover, if this is seen from the free-styled flap perspective, it requires supermicrosurgical expertise. This case report hence, serves as a fusion of all the above concepts...
February 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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